Reflections of a Dietetic Intern Through the Inaugural WVU ISPP Class

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The “buying local” trend has emerged within the last few years. In the United States, especially in West Virginia, food agriculture businesses are finding themselves at critical and electrifying times of opportunity. From 2006 to 2008, West Virginia small restaurants and hotels showed a 360% increase in purchases of local products. In the 2012-2013 school year, the WV Department of Education committed $250,000 in school food funds for local purchases. More than a dozen of county school systems reported buying directly from West Virginia farms in 2012, while four of these began buying locally since September 2011. Even the Martinsburg VAMC sees fresh, healthy meals as an ingredient of recovery for their patients and has spent over $23,000 on local food.

From 2002 to 2007, 39% more local West Virginia farmers began selling directly to consumers. And the dollar amount of direct-to-consumer sales increased by 55%. This means that farmers are capturing a greater portion of the consumer food dollar by marketing products as directly as possible from farm to table as demand grows, new business models are also emerging to provide the kinds of processing, aggregation and distribution required to meet the needs of sophisticated buyers.

This growth creates jobs for farmers and also for other parts of the state’s economy. A recent study by Downstream Strategies, LLC and WVU showed that if West Virginia farmers grew enough produce to meet the in-season fresh produce needs of all state residents, the shift would generate 1,723 new jobs and would result in about $190 million being retained in the state instead of flowing beyond its borders. Increased local sales of West Virginia products also creates the need for businesses that collect, process and distribute local food, which creates more local jobs. For example, one Iowa study found that every 1,000 cattle sent to small meat processing facilities supported 7.4 processing jobs.

So a common question that you might find asking yourself is… What exactly does “buying local” mean? There is no universally agreed-upon definition for the geographic component of what “local” or “regional” means, consumers are left to decide what local and regional food means to them. A 2008 survey found that half of consumers surveyed described “local” as “made or produced within a hundred miles” (of their homes), while another 37% described “local” as “made or produced in my state.” The ability to eat “locally” also varies depending on the production capacity of the region in question: people living in areas that are agriculturally productive year-round may have an easier time sourcing food that is grown or raised 100 miles (or even 50 miles) from their homes than those in arid or colder regions, whose residents may define “local food” in a more regional context.

The Morgantown Farmers’ Market, for example, sells products that are grown or made within 50 miles of Morgantown city limits. So all of their products are supporting small family farms.

So, West Virginia has developed a “food charter” that’s designed to help us all focus, measure and celebrate our collective progress towards stronger local food systems. This Road Map for the Food Economy offers a vision for WV’s local food economy and provides ways of measuring how statewide and local policies, programs, and community efforts are contributing to the strength of this food economy. The Road Map is broken down into 2 parts: an action plan for building a food and farm economy over the next 5 years; and a “Food Economy Score Card” which allows us to measure the cooperative progress towards the goals of the action plan. The Food Economy Score Card will be updated annually and then the positive changes and progression will be distinguished in an annual report.

This Road Map is for everyone!It’s offered more as a tool to help people (and consumers) in West Virginia understand the key opportunities of the food policies and economy. Local government, citizens groups, policy makers, farmer groups, foundations, agencies, economic developers and other concerned groups are invited to adopt or adapt the Road Map as a guide to form an action plan for their own efforts.

So, how can you get involved?

–Adopt the Road Map for the Food Economy charter: encourage your local government, citizens group, legislators, farmer organization, community foundation, economic developers or other concerned agencies to sign on at

–Stay connected to statewide organizing efforts through the West Virginia Food & Farm Coalition by signing up for our newsletter, and by attending statewide events hosted by other groups — such as the West Virginia Small Farm Conference, hosted by WVU Extension Service and its West Virginia Small Farm Center.

–Buy Local: set a goal for how much your family, business or agency will spend on local food. At home, consider buying at least $10 worth of locally produced food per week. At work, consider sourcing at least $500 worth of local food for events and meetings each year.

–Find simple ways to work on the Road Map’s action items within your own community. Tell your school superintendent about the importance of Agriculture Education; let a farmer know about farm to school opportunities, or help start a nutrition education class at your local farmers market. If you are part of a civic organization, help that organization choose an action item to work on this year.

Why should the Road Map matter to you?

The problem that I’m really trying to shine light on is the fact that food access has a HUGE effect on food insecurity in the U.S. right now. The State Indicator on Fruits and Vegetables 2013 reports that the percentage of census tracts with at least one healthier food retailer within a ½ mile of tract boundary in West Virginia is at 59.3%. Currently, West Virginia does not have a healthier food retail policy. West Virginia also does not currently have a state-level farm-to-school/preschool policy. The entire state only has 1 food hub. Yes, only one! And West Virginia has no local food policy councils. That’s right… zero!

As a community why can’t get try to enclose this gap in food access with the products that are right in front of us? Well, only time will tell how this community attempts to resolve this problem.

March 13th celebrates Registered Dietitian Day! This celebration occurs every year during National Nutrition Month, which is March. RDs are the public’s go-to healthcare professionals when they need reliable nutrition information, in this field. RDs pull from their experience to create a personalized nutrition plan for people of every age. These are the professionals that are able to separate facts from fads and translate nutritional science into information you, the consumer/client/patient, can use!

Dietitians can improve the health of Americans and save money through healthcare costs. Medical nutrition therapy (MNT) provided by RDs is critical in preventing the top 3 chronic illnesses. It is well documented that MNT is associated with a decrease in utilization of hospital services of 9.5% for patients with diabetes and 8.6% for patients with cardiovascular disease. Also noteworthy is that participation in community-based programs that focused on improving nutrition and increasing physical activity had a 58% decrease in incidence of Type 2 Diabetes.

Registered Dietitians assist to promote a net decrease in healthcare utilization and costs for most people. The Robert Wood Johnson Foundation estimates that in Idaho, for every $1 spent in wellness programs, companies could save $3.27 in medical costs and $2.73 in absenteeism costs. Some interventions have been shown to help improve nutrition and activity habits in just 1 year and had a return of $1.17 for every $1 spent. Reducing the average BMI in the state of Idaho by 5% could lead to health care savings of more than $1 billion in 10 years and $3 billion in 20 years.

Well, unfortunately Wild and Wonderful West Virginia isn’t as lucky as ole Idaho. West Virginia still leads the nation in obesity, and was recently named the state with the highest number of overweight residents in the union. According to the 2012 Gallup-Healthways Well-being Index released last week, 33.5% of West Virginia’s population is considered obese.

Mississippi is the closest with an obesity rate of 32.2%. Arkansas has a rate of 31.4%, Louisiana is 30.9% and Alabama is listed at 30.4%, to round out the top five.

Residents of the Mountain State believe that a reason for the high obesity rate is the change in physical jobs and increase in availability of fast food. The combination of lack of physical activity and the ready access of fast food and junk food in homes has really contributed to the epidemic. On the flip side of our state, nutrition-related efforts seem to be working as West Virginia is no longer in the top five for childhood obesity!

With the help from schools and communities, West Virginia is increasing physical activity and need for healthier foods. As a unit we are advocating and promoting activity and nutrition. I think it seems to be helping! All thanks to those RDs out there!!!

Job outlook: According to the Bureau of Labor Statistics, Nutrition and Dietetics careers are expected to increase much faster (by 20%) than other jobs by 2020 and faster than many other industries within health care. In 2010, the median annual salary for RDs was $53,250, at $23.60 an hour. And the number of jobs available in the nutrition and dietetics field was 64,400.

Well, let’s see… As the Community Wellness ISPP (Individualized Supervised Practice Pathway) Dietetic Intern, it’s my responsibility to get my Action Team in the community and promoting nutrition education and overall healthy thinking and decision-making by Morgantown’s population. So, for this meeting that took place on Monday February 11th at 5:30pm on WVU’s Evansdale campus, we had a mapped out plan of what we needed to address and where we need to go, in terms of community wellness.

WV Action For Healthy Kids (AFHK) Undergraduate intern:

We decided that that on behalf as an Undergrad intern, 2 posts per week on WV AFHK’s Facebook page would be an ongoing assignment. This intern already has a requirement of 1 post per week from WV AFHK, as a stakeholder within our program. So, 3 posts total is required. And these posts are reflective of child/adolescent nutrition education or areas of that concentration,

The Undergrad intern was asked to help develop and deliver a grant writing workshop for Pierpont Community and Technical College On March 8th by our WV AFHK stakeholder. So, by utilizing these resources, an assignment will be presenting “Grant Writing 101” to the next Student Dietetic Association on March 12th. This will give the Undergrad intern, who’s presenting, experience at public speaking AND give these Human Nutrition & Foods students an opportunity to gain knowledge, tips, and resources as to how the process of grant writing exists.

Another joint requirement is developing a newsletter every month. The WV AFHK stakeholder currently has this intern create 1 newsletter per month. So, I assigned an additional newsletter to be written and I assigned possible topics for the intern to choose from, along with coinciding deadlines. So, in total 2 articles for a newsletter will be due from this intern. Here are the topics I gave the intern the choice to choose from for each deadline:

We’ve decided that most of our projects/presentations that we work on in our group, we will work as a team. I made this very clear at the very first meeting. I want to make sure everyone is involved with everything. That being said, an after-school nutrition education program was assigned to this Undergrad intern. Thankfully, the intern has help from our Community Wellness Action Team. So, I already had the thought in my mind that I wanted an after-school program based on something similar to a Rachel Ray show where she travels around the country. I wanted to implement a program where children at the Shack Neighborhood House can get the opportunity at becoming exposed to different regions of the country and still have that nutrition component as well. So, we created a program called “Our Healthy Roadtrip”. This program will last 6 weeks long and be held every Monday from 4:15pm-5:15pm. Our start date is March 4th and we’ll need a minimum of 2 volunteers for every lesson. Each lesson will consist of a nutrition education component, a section on exposure to that specific region’s food habits, and then a snack and interactive activity for the students.

Another project is organizing the Oxfam Hunger Banquet, that the Undergrad intern has named Mountaineering Against Hunger. Right now the beginning process is in effect where committees are filling up. Then, once these 3 committees are fulfilled, then further actions like venue planning and food donations can take place.

Other projects and events that our Action Team is in the process of organizing is Father’s HAND, Cross-Country Casserole Club, and Family Fun Night.

The Children’s Discovery Museum of West Virginia Undergraduate Intern

All of the events for the CDMWV for the semester are, for the most part, set in stone and already organized. It is this intern’s responsibility to complete these tasks and delegate any other duties needed. This Undergrad intern is working with another Graduate student on developing a program called “Healthy Passport”.

I also assigned this intern to develop a timeline of all events that take place at the CDMWV throughout the entire semester. This way, we can organize, and possibly even collaborate with another organization, other events and programming within the Morgantown, WV area.

As a Community Wellness Action Team I have decided that we will have our own National Nutrition Month campaign. National Nutrition Month is celebrated throughout the entire month of March and this year’s theme is “Eat Right, Your Way, Every Day”. Specifically, March 13th is National Registered Dietitian (RD) Day.

Sooo…… I think I somewhat caught my team off guard by telling them my idea. I want us to use guerrilla marketing with National Nutrition Month and utilize the Student Dietetic Association to do so. My plan is to recruit HN&F students to draw USDA’s MyPlates ALL over the Morgantown area, specifically on all 3 campuses, in different colored sidewalk chalk. And I plan on having people doing so on a daily basis, in case weather prevents us from our guerrilla nutrition parade. Then, on March 19th, the Student Dietetic Association will have a table outside of the Mountainlair on the downtown campus and have a GIANT MyPlate drawing in front of our table on the ground. At our table we’ll have lot of fun interactive nutrition activities, handouts, healthy recipes, healthy snacks, and food guide pyramids from all over the world, including USDA’s MyPlate- of course. I think this will be a really innovative and unique approach at National Nutrition Month (NNM) and promoting health awareness on a large scale.

USDA MyPlate Food Guide

One of the intern’s assigned projects

The Shack Neighborhood House. A primary stakeholder within our program!

WV AFHK is a stakeholder within our ISPP Dietetic Internship

The Children’s Discovery Museum of WV collaborates with our program for special eventing and nutrition programming on several different levels.

Well, the day finally arrived! Saturday February 2, 2013- The “Love Your Heart Fun Lunch” free heart screening event took place at the WVU Heart Institute in the Suncrest Towne Centre. The ISPP Dietetic Internship was there and we were ready to educate the community all about…. (drum roll please)… PORTION DISTORTION! Since the ISPP Dietetic Internship has an Emphasis Area of “Leadership in Community Wellness”, our table was geared towards addressing what so many Americans find themselves becoming confused about- serving sizes, portion control, and easy ways to remember how to stay healthy.

We were asked by the coordinators of the event to wear a red shirt and dress pants. All of the table covers were provided by the staff and they even provided tape for me to use when I was setting up and hanging our “How Well Do You Know Your Portions” poster. The participants received a stamp from the ISPP Dietetic Internship table when they walked through our demonstrations and interacted with our activities. These stamps went on a participant bingo card, which entered them for a chance to win a door prize if they visited each table in the waiting area. Our first activity at our table was Kaylyn’s “Fast Food Quiz”, which was very intriguing to everyone at the event. Our second interactive, hands-on activity was a portion exercise I created. I had two bowls displayed in front of a bowl of rice. The purpose was to have participants portion out how much they thought a normal portion of brown rice was, then portion the appropriate amount into the other bowl to compare the two bowls side-by-side. Only four people tried the activity so, maybe next time I try to implement something like this again, I should include directions displayed for participants to see so there’s no confusion. Overall, the event was a real success for the WVU ISPP. Everyone seemed really open and receptive to the information we were providing to them.

I got to sneak a picture of the sign when you enter the 2nd floor of the WVU Heart Institute

On Friday February 1st, the ISPP and GDI Interns were asked to come to the WVU Heart Institute to set up for the upcoming event that was taking place the next day. Elaine Bowen, a WVU Extension Specialist, asked us to attend the “Love Your Heart Fun Lunch” event. This event is a free health screening fair that participants attend, on a first come, first serve basis. The day before the event, volunteers and coordinators took time out of their day to prepare for the health screening extravaganza. Volunteers from the School of Nursing and the School of Pharmacy, from WVU’s Health Sciences campus (HSC), were in attendance at the set up event. It was communicated that we, “nutrition people”, arrive to start help setting up at 5pm on that Friday. Well, since there was only two ISPP Dietetic Interns (including myself) that were going to be responsible for our “Community Nutrition” table, I told Kaylyn (the other ISPP Dietetic Intern) that I would go to the set up event. I did this because there really was no reason to have two people setting up our table. I arrived with my materials, posters, handouts, and other nutrition equipment and waited for instructions, with other students from HSC. To my surprise, when introductions from coordinators started to begin, I was introduced to the whole group of students because I was the only nutrition person who arrived to set up prior to the event. The GDI Interns were administering the screening process (meal planning) of the health fair and the ISPP Interns were responsible for a “Community Nutrition” table in the waiting area for participants to interact with and gain a little more health-related information. Since I was the only nutrition person to attend the event set-up, this gave me a few opportunities to take time to meet everyone that was involved in the planning and organizing of the event. The coordinators provided everyone with an itinerary and a map of the heart screening. The coordinators also shared with the group a Proclamation signed by the Governor of West Virginia, which was my first time seeing anything like that before. Then, the other volunteers were given a tour of each station of the heart screening maze for the next day. Since the ISPP Dietetic Internship table was in the waiting area with other community partners, like the School of Dentistry and EMS, I opted to help others move furniture and carry items inside from coordinator’s cars. I actually ended up getting the ISPP table set up fairly quick so, I helped with anything that anyone needed help with. Overall, I’m glad I came to set up because it made the next morning less stressful for Kaylyn and I. I also had the opportunity to network with other students and faculty in WVU health-related fields.

Starting from the left side of our “Community Nutrition” table

The middle section of our table- pre-event status

And the right side of our table. The only piece to this puzzle that was missing was Kaylyn’s “Fast Food Quiz”, which she brought the next morning.

A visual I created for participants to realize what the MyPlate actually looks like, compared to an actual oversized plate that most Americans use in their home on a daily basis.

The volunteer’s map of the heart screen- to look over in case participants need help finding stations the next day.

Overall- what the ISPP Dietetic Internship Community Nutrition table looked like the night before the event took place!

As an ISPP Dietetic Intern, we have an emphasis area of “Leadership in Community Wellness”. Therefore, each intern is assigned an Action Team based on an area of “LCW” that we are most associated with. I am the ISPP Dietetic Intern responsible for the Extended Community Wellness Action Team. This team is comprised of WVU Human Nutrition & Foods students that applied for positions as Undergraduate Interns (HN&F 495 Independent Study credit).

The first Extended Community Undergraduate Intern Action Team meeting took place this week on Tuesday January 29th. On the action team, I have an undergraduate intern for (1) WV Action For Healthy Kids, (1) Children’s Discovery Museum of West Virginia, and (1) The Shack Neighborhood House and Davis College of Agriculture, Natural Resources, and Design. Bringing my team to a total of 3 students. In our meeting, I distributed tables of meetings, projects, programs, and presentations that each undergrad intern will be responsible for throughout the semester. I distributed all 4 tables to each student on my action team so, everyone knows what everyone else is doing and playing a role in. I think this will help prevent any confusion as to what each undergrad intern’s role will be throughout the semester.

As a team, I expect all 3 students to attend all Action Team meetings, as well as keeping notes of every meeting and emailing these notes to me by the Sunday after our meeting. This way I can see if the students understand their role on the Extended Community Wellness Action Team and if anything needs to be clarified at the next meeting. Currently, I have told this Action Team that our focus is to get “The Casserole Club” organized and lessons start being developed. At the end of the semester, I expect a PowerPoint presentation of what everyone completed throughout the semester. This presentation may OR may not be a group presentation, depending if our final meeting is concurrent with the other Action Teams (Collegiate, Worksite, Social Media).

AFHK Undergraduate Intern

Current involvement

Newsletter

Facebook page- keep a documented file of all your posts

Grant workshop

Document all meeting notes about workshop

Save and email all supplemental materials from workshop

Meetings

Document all meetings attended and submit

WV AFHK chapter meetings

SWAB meetings

Semester project

Create a nutrition education program based on an AFHK theme/idea

This theme does not have to be Smarter Lunchrooms

This project can be utilized within the Community Undergraduate Internship Action Team

Can work with SNH or CDM of WV to utilize child/adolescent populated organizations

BE CREATIVE!!

Compose a 1 page (maximum) article based on a topic given by Community ISPP Dietetic Intern

Post article on AFHK Facebook page

Submit on Ecampus by deadline

These topics that will be assigned by Intern, will be based on your AFHK project

“Happy School”- A program for new, young parents with young children that meet Tuesday, Wednesday, and Thursday 9:30am-12pm. So, our program would either take place Tuesday or Thursday 10am-11am OR 11am-12pm.

Service-learning, aka learning through service, is a way students enrolled in dietetics classes can apply what they are/have learned to real-life situations as they work to meet the needs of a community agency/organization. By linking academic learning to community service, service learning promotes civic engagement. In nutrition education, civic engagement in the community can thoroughly expose students to important public health issues like evidence-based practice, advocacy, cultural aptitude, insurance, community policies, and aspects that distinguish service-learning from other forms of volunteer experience. When used effectively, service-learning provides the experiential, reflective, and problem-based inquiries that have been shown to facilitate students’ sustained learning. Service-learning meets the public’s expectation for increased accountability from institutions of higher education to document that students are actively learning and being prepared for their chosen career in nutrition.

Service-learning is a mutually beneficial experience.

The effectiveness relies on the partnership of academic-based and community-based practitioners to guide students in processing information through continuous reflection and critical thinking. Guided reflections reinforce students’ intellectual sense-of-self and facilitate their understanding of the contribution they can make through their chosen profession to the immediate and global community.

Service-learning is an opportunity for students to gain dietetics-related experience.

The ways in which students in dietetics and the community-at-large can benefit from service-learning through increased understanding of nutrition programs, food systems, and group/client interactions is clear. Although the intent of service-learning for the student is to instill a value of civic engagement and enhance learning, an additional benefit of service-learning experience can assist them in developing dietetics-related skills that would result in strengthening their DI applications, and increasing their potential for becoming effective interns.

The demand for DIs has increased drastically since 2003. However, the supply of internships has not kept up with demand, so currently the rate of acceptance into Dis is approximately 50%. Many well-qualified students do not get matched to an internship because of the shortage of internships. In fact, ACEND now provides data on internship availability relative to positions available on the AND website so students in DPDs are informed of this situation.

The AND is addressing the internship shortage with a new route for obtaining supervised practice experience- the Individualized Supervised Practice Pathway (ISPPs). The ISPPs are offered by accredited DPDs (Didactic Program in Dietetics), DIs (Dietetic Internships), and Coordinated Programs that choose to offer ISPPs. Students who are not matched with an internship through the regular application process, those who hold a doctoral degree and overseas RDs are eligible to apply for ISPPs.

How service-learning can be incorporated into courses.

One way to provide students with dietetics-related experience in actual practice settings without burdening RDs is to provide students with service-learning opportunities in undergraduate courses. Many universities have offices and personnel with service-learning expertise dedicated to assisting faculty in implementing service-learning. Service-learning can be integrated into semester-long courses as a requirement or offered as an added component to a course for which participating students receive additional academic credit.

It is important to remember that the purpose of service-learning experience is to instill a sense of civic duty in students and making them aware of the inherent value of their contribution to the community. This way they can enrich their classroom-learning experience. Service-learning experiences are intended to be mutually beneficial rather than “mini-internships” that provide training to students. As students complete their service-learning experience with an understanding of the importance of service and the realization of how providing service enriches their lives, they also will be well-prepared for success in their DIs and professional careers.

MyBowl is an education tool that is an extension of the MyPlate food guide, used across the United States. MyBowl is designed to show how easy it is to meet dietary recommendations with meals served in bowls, like breakfast cereals.

MyPlate is a recognized education instrument developed by the USDA that brings to life the 2010 Dietary Guidelines for Americans, to help people get the most nutrition from their meals. A recent survey shows that 100% of RDs are aware of MyPlate and 99% of them agreed that it is a helpful tool. There’s an opportunity to help consumers further understand and apply MyPlate recommendations to meals people eat in bowls, too. Using specific visual cues, images, and icons are effective ways to educate the public. MyBowl helps illustrate and extend the message that all food groups can fit into all meals, even those traditionally served in bowls like cereal breakfast, soup, and salads. 95% of RDs expect the MyBowl graphic to be used in addition to MyPlate.

Like MyPlate, MyBowl is a simple visual cue to help people get the most nutrition from meals served in bowls. MyBowl is a simple tool that helps people understand how specific foods fit into “food groups”, like how a cereal breakfast with fruit delivers servings from “grains, dairy and fruit food groups”. MyBowl was purposefully created to match the features of MyPlate. The MyBowl colors are identical to those used in MyPlate. The positioning and size of the colored bands around MyBowl reflects different types and amounts of foods and food group combinations that could be enjoyed in a bowl. When used as an online interactive tool, the size and color of the bands around MyBowl will change to reflect the amount and type of foods actually in the bowl. ChooseMyBowl.com is an interactive site that features tips, tools and meal plans to show people how to make smart choices and enjoy a variety of food groups and nutrients in delicious bowl meals.

People need help starting the day with a balanced breakfast; research shows:

While more than half of all adults would like to eat breakfast every day, only one-third actually do.

Nearly all moms want their kids to eat breakfast every day; however, 40% of moms report their child doesn’t eat breakfast daily.

While nearly all toddlers and preschool-age children are eating breakfast, consumption of breakfast decreases as American children grow older. 77% of young children eat breakfast every day, but the number falls to 50% in the middle-school years and 36% among high school students.

The latest research from the International Food Information Council (IFIC) shows people who eat breakfast regularly have higher intakes of several vitamin and minerals.

The same research noted that breakfast skippers may not make up for missed nutrients at other meals during the day.

MyBowl helps people realize that eating breakfast can be a fast and easy solution to achieving a varied diet and meeting nutrient needs.

When it comes to breakfast, cereal with non-fat milk is a nutrient-dense choice eaten in a bowl, delivering several essential nutrients in less than 150 kcal per serving, on average. Cereal with milk is the leading source of 10 nutrients in children’s diets and provides four nutrients, including fiber, most likely to be lacking in kids’ diets. Cereal with milk may deliver good or excellent sources of the 4 nutrients of concern- calcium, potassium, vitamin D, and fiber. Studies show that cereal eaters have higher intakes of many essential nutrients including B vitamins, calcium, vitamin A, and vitamin D. Numerous studies show that a cereal breakfast is associated with a lower BMI in both children and adults. Cereal with milk is an affordable breakfast option- costing just 50 cents per serving, on average.

A cereal breakfast can help Americans get more fiber, which was noted in the 2010 Dietary Guidelines for Americans as a “nutrient of concern”. Nine out of ten Americans don’t meet daily recommendations for fiber. On average, Americans consume just about half of the required fiber that they need each day. Many experts think Americans poor fiber intake is a public health concern for both adults and children, with potential consequences that may increase the risk for several chronic diseases and obesity. In a recent survey, 90% of RDs agreed that a cereal breakfast is one of the best ways to easily increase fiber intake. On average, Americans only get 18% of their daily fiber at breakfast.

The MyPlate design published by the USDA. This replaced the MyPyramid in June 2011, ending 19 years of USDA food guide diagrams.

A Community Dietitian counsels individuals and groups on nutritional practices designed to prevent disease and promote health. They work in places such as public health clinics, home health agencies, and health maintenance organizations, community dietitians evaluate individual needs, develop nutritional care plans, and instruct individuals and their families. Dietitians working in home health agencies provide instruction on grocery shopping and food preparation to the elderly, individuals with special needs, and children.

Community RDs educate the public on topics related to food and nutrition. They often work with specific groups of people, such as pregnant women. They work in public health clinics, government and non-profit agencies, health maintenance organizations (HMOs), and other settings.

Community RDs work with wellness programs, public health agencies, home care agencies, and health maintenance organizations. These dietitians apply and distribute knowledge about food and nutrition to individuals and groups of specific categories, life-styles and geographic areas in order to promote health. They often focus on the needs of the elderly, children, or other individuals with special needs or limited access to healthy food. Some community dietitians conduct home visits for patients who are too physically ill to attend consultations in health facilities in order to provide care and instruction on grocery shopping and food preparation

College students interested in this field should consider courses in foods, nutrition, institution management, chemistry, biochemistry, biology, microbiology, and physiology. Other courses include business, mathematics, statistics, computer science, psychology, sociology, and economics, and communications. WVU’s own DPD program awards degrees in a (1) Bachelors of Science in Human Nutrition and Foods or a (2) Bachelors in Agriculture with an Emphasis in Nutrition.

Dietitians need at least a bachelor’s degree in dietetics, foods and nutrition, food service systems management, or a related area. Those who have a master’s degree or have specialized training in renal or diabetic diets should experience good employment opportunities. Students interested in research, advanced clinical positions, or public health may also need an advanced degree. Requirements vary by State. As a result, interested candidates should determine the requirements of the State in which they want to work before sitting for any exam. Although not required, the Commission on Dietetic Registration (CDR) of the Academy of Nutrition and Dietetics (AND) awards the RD credential to those who pass an exam after completing their academic coursework and supervised experience.

– Median salary working in food and nutrition management: $60,000 and up

Top pay: $76,000

Total jobs, as of 2010: 64,400

Employment of RDs is expected to grow 18-26% for all occupations through 2014 as a result of increasing emphasis on disease prevention through improved dietary habits. A growing and aging population will boost the demand for meals and nutritional counseling in hospitals, residential care facilities, schools, prisons, community health programs, and home health care agencies. Public interest in nutrition and increased emphasis on health education and prudent lifestyles also will spur demand, especially in management. In addition to employment growth, job openings will result from the need to replace experienced workers who leave the occupation.

Betty Forbes, the previous Community Dietitian at WVU, retired last year. This is her teaching a HNF 472: Community Nutrition class.

Geography of a RD

The top five best-paying states for dietitians, according to the Bureau of Labor Statistics are:

– Connecticut

– Maryland

– New Jersey

– California

– Hawaii

– Dietitians in these states earned median wages of between $59,390 and $62,260 annually.

High-paying metropolitan areas that the BLS identified include:

– the Bethesda, Maryland area

– the San Jose/Sunnyvale, California area

– the Oakland/Fremont, California area

– Waterbury, Connecticut

– Leominster/Fitchburg/Gardner, Massachusetts

– These city areas pay dietitians median wages between $69,380 and $83,320 annually